The Mumbai Haad Sena: Community Radiology Education for a city – Part I

The best way to learn anything is in small sessions that are focused. Ones that highlight important things rather than rambling details and ones that are delivered in an entertaining manner. Most everything else contributes constructively to the sleep cycle!

I am proud to inform you that through a group of dedicated radiologists I am part of a regular monthly radiology education programme in the city of Mumbai. I am also happy to say that its simplicity is probably the cause for its success. What I am about to share with you is top secret and a little dedication will enable you to develop a similar programme in your city and ramp up the quality of radiology education nationwide.

The piece is written in two parts, the first that focuses on the actual setup and the second on early and future plans for development.

So what is this success story and what are its ingredients?

1. The core group: To start, the activity requires a small group of like-minded radiologists (residents and/or faculty) who agree to give a small amount of time on a regular basis towards education. It is important that the group be small, cohesive and bereft of ego hassles. Furthermore, it is good if everyone is from different institutions. The group must have the common goal of delivering the best possible education to residents irrespective of where they come from and preferably at no cost. In our case, most of our core faculty consists of 2-4 people at any given time, 33-36 years of age and everyone comes from a different institution.

2. Advisors: Make sure this group is small too. It should consist of ego free dedicated educators in your area. Specially ones who are not at loggerheads with other heads of departments in the city. One should also include any other faculty that wishes to be involved but is unable to dedicate time regularly. The senior advisors add legitimacy to the group while others provide suggestions for topics, space and feedback (which the core group filters as needed). In our case, we have one prominent head of department, one former head of department and a whole horde of radiology colleagues who encourage us and provide support as and when they can. They have helped us with lectures, cases, space, feedback and new ideas amongst many other useful things. They also serve as the word of mouth to inform residents about the existence of the entity.

3. Curriculum: This is probably the most important aspect of what one sets out to do. We figured it was impossible to deliver all information at these conferences and so decided what we would focus on is providing a basic platform from which residents could build a more detailed knowledge base. We also decided to pick a less emphasized subspecialty (musculoskeletal radiology) as the focus of the conference. Initially, we began in a haphazard manner by just deciding to show cases and teach residents to take them interactively but eventually, we decided to move to a more structured approach. Presently, we have a 45-60 minute didactic session followed by an interactive case session. We have also decided to structure the curriculum into core topics (eg: approach to plain film trauma, arthritis, tumours, hardware, infection) which we will repeat every year in the first six months and advanced topics (MRI, US) which we will vary annually.

4. Timing, regularity and location: It is important to find a time, place and frequency that allows maximum attendance. We figured 6 PM on Thursdays at a centrally located institution (in our case Parel) is perfect. Most people are done with work by 5 PM, which gives them enough time to make it. Thursday is far enough from the weekend that it does not eat into vacation. Central location allows everyone to come. A monthly session allows faculty and residents to recuperate, be fresh and prepared for each session.

5. Session monitoring and feedback: This is where the core group plays an important role. Every session must be monitored for quality of content, delivery and resident satisfaction. Feedback forms are also important. They should be handed out at the beginning of the session and collected at the end. Space should be kept for resident suggestions and e-mail addresses so a mailing list can be developed. If you listen to the audience, it comes back. It is also a good idea to document feedback for future developments and retrospection. We found that suggestions were important in our selection of topics, improving image quality and changing our location. Our own experience with electronic feedback has been quite poor!

6. Finding teachers: Every institution is blessed with their knight in shining armour and it is through residents and fellow radiologists that we get to know who they are. Dr. A at Hospital X teaches temporal bone well and Dr. B at hospital Y is a master of neck spaces while Dr. C at hospital Z is superb at bone tumors. This is how we find them. In addition, we all happen to have friends who are radiologists overseas who need to see their families in India. When they make the fatal mistake of telling me they are in town, they are gagged, kicking and screaming and asked to deliver their best to the group! Most of them love to speak on their pet topics and are always open to ways in which to deliver information. We have found that requesting them for a nice 45-60 minute lecture followed by 10-12 interactive cases to drive home the salient aspects works well. We stress on emphasizing important practical points and spending less time on inane details and long lists of syndromes. In some cases, we’ve requested them to get their residents. Involved and residents have delivered excellent lectures with guidance from these teachers. The results have been fabulous.

7. Follow up: It is always important to follow up each session with a brief note that summarizes the salient points. I sometimes find things listed in a structured manner in a textbook make it difficult for me to figure out what is important and what is not. This is what the note should do. We make it a point NOT to distribute the lectures (power points) through this medium. Lectures are the work of the person preparing them and given the little respect that most people seem to have for intellectual property, we let the lecturer decide on how they would like their information to be shared.

Our experience in the first four months was quite varied. The first session had 60-80 residents, the next had 20, the third 12 and fourth had 25. After that, we consistently see 60-80 residents. We even have a few residents who come regularly from Pune, which is quite nice. This makes sure we have our conferences as planned as we can’t let their trips go waste!